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When to go to the hospital in labour

Updated: Sep 15, 2022

You've packed the labour bag, the car seat is strapped in ready for its precious cargo, the contractions have started, BUT how will you know it's time to make that drive to give birth?

Let's take a look at the signs it's time to head to the labour ward or birthing unit.

As a FEDANT accredited antenatal teacher one of the most common questions I receive during classes is ‘How will we know when to head to the hospital?’

The simplest answer is, if you decide you need pain relief and are not coping at home, or when you’re in established active labour.

Now in theory you would be dilated 4 centimetres plus, and the cervix will be thinning down (effacing) to paper thin, but as you’re unlikely to be checking the favourability of your own cervix, we’ll put those aside for now and pay attention to contractions and common behaviours instead!

Why does it matter?

Birth requires a delicate cocktail of hormones to work efficiently and comfortably. When the body releases adrenaline during the latent or the early active phase, it can impact the delicate hormonal balance, slowing down or even stopping labour progressing.

Now I don’t know about you, but most of us don’t associate hospitals with happy, comfortable memories, so it is common to experience an adrenaline surge on arrival, until the brain assesses the space as ‘safe’, and we can get back into the birthing ‘bubble’.

Adrenaline is less likely to impede labour the further along we are, as the closer we get to the 2nd stage (pushing) we enter the final phase of labours first stage, transition, this phase comes with a physiological adrenaline spike to help us energise, ready to push baby out.

Oxytocin powers uterine contractions, and is released when we feel safe, loved and happy, your home, and familiar surroundings are likely to aid in the production of oxytocin far more effectively than the bright, daunting hospital, so knowing when the right time to leave home, (if you're not having a home birth of course) is important.

Both Hinchingbrooke and The Rosie maternity units have beautiful midwife led units that aim to provide low adrenaline atmosphere best suited to oxytocin production, but you'll still need to walk through the main entrance areas to get there, so make sure you know the quickest route!

What are active labour contractions?

Whilst early labour includes contractions, they are usually short and irregular, contractions during the latent phase, the first phase of the first stage of labour, can start and stop over a few hours or even days (known as primordial labour).

The main difference between latent phase and active phase of labour is that the contractions start to come at regular intervals, getting longer, and stronger, lasting 45 – 60 seconds.

To minimise the effects of adrenaline, and allow labour to progress as efficiently as possible, it is beneficial to stay at home until the contractions are strong, either coming every 5 minutes, lasting for a full minute, for a full hour, this is a good indication of established labour an easier way to remember this is the ‘511’. Alternatively, as every body, and birth is different, another pattern to watch out for is 3 contractions in 10 minutes, lasting 1 minute, for an hour, 3 in 10.

How will I know I am in active / established labour?

As active labour picks up, it is common to see the birthing person be drawn down towards the ground during contractions, finding stability in the solid floor as relaxin surges, preparing the hips to widen and open, and the pelvis becomes increasingly unstable.

During the latent phase of labour, you will be able to speak or gesture through a contraction but during active labour you can only focus on the contraction, breathing through it and keeping the abdomen as relaxed as possible.

In latent labour life is normal between contractions, and you are most likely able to chat in the spaces between them and complete some everyday tasks, but during active labour the spaces in between contractions are time to breathe in the endorphin ‘high’ and focus on staying ‘in the bubble’ conversation and general interaction will reduce or even stop entirely.

Top tip

Create an environment somewhere at home ready for birth, create the perfect 'nest'. Prepare an area with music and low lights. Ensure a space which encourages you to move, helping baby to descend. Pillows, sturdy tables/sofa and birthing balls are all beneficial. Make the space so wonderful, you're reluctant to leave it! Boost Oxytocin to keep those contractions working efficiently. Endorphins flowing and flooding the body with natural pain relief 200 x stronger than Morphine and adrenaline level at bay.

Get antenatal educated!

Understand physiological birth!

If you don't know why all these hormones I keep going on about matter, or how to manage each stage of labour, then book one of my Cambridgeshire based face to face antenatal courses a 1-2-1 Zoom with me now.

*The information contained in this blog is given as generic informative material and is not intended to replace medical advice. As always if you have any concerns regarding your health/pregnancy contact your medical team for specific advice*

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